Mission: Lifeline Glossary

Updated:Aug 23,2013

12-lead electrocardiogram (ECG)

A test using a device that measures the electrical activity of the heartbeat and can help medical personnel determine if a heart attack has occurred and whether the heart attack was a STEMI or non-STEMI event. When a 12-lead ECG is done, 12 wires ("leads") are attached to the arms, legs and chest. These wires each record electrical impulses, but from a different position in relation to the heart.

Acute myocardial infarction

The medical term for a heart attack, which occurs when the blood supply to part of the heart muscle itself - the myocardium — is severely reduced or stopped.

Angioplasty

A procedure used to treat patients with a partially or completely blocked artery that restricts blood flow through the heart. A type of percutaneous coronary intervention (PCI), this procedure requires a slender balloon-tipped tube to be threaded from an artery in the groin to a trouble spot in the artery of the heart. The balloon is then inflated, which compresses the blockage and widens the narrowed artery to restore blood flow.

Balloon inflation

Another name for angioplasty, which is a surgical procedure used to treat patients with a partially or completely blocked artery that restricts blood flow through the heart. A type of percutaneous coronary intervention (PCI), this procedure requires a slender balloon-tipped tube to be threaded from an artery in the groin to a trouble spot in the artery of the heart. The balloon is then inflated, which compresses the blockage and widens the narrowed artery to restore blood flow.

Cath lab

The department in a medical facility that specializes in cardiac catheterization, which is a procedure to examine blood flow to the heart and test how well the heart is pumping.

Door-to-balloon time

The amount of time between a heart attack patient’s arrival at the hospital to the time he/she receives percutaneous coronary intervention (PCI), such as angioplasty.

Door-to-needle time

The amount of time between a heart attack patient's arrival at the hospital to the time he/she receives clot-busting medications, referred to in medical terms as fibrinolytics or thrombolytics.

Electrocardiogram (ECG/EKG)

A recorded tracing of the electrical activity of the heart.

Emergency Medical Service (EMS)

A system of health care professionals, facilities and equipment providing pre-hospital emergency care.

A statute that governs when and how a patient may be (1) refused treatment or (2) transferred from one hospital to another when in unstable condition. The EMTALA was passed as part of the Comprehensive Omnibus Budget Reconciliation Act of 1986, and is sometimes referred to as "the COBRA law".

Fibrinolytic therapy

The use of pharmaceuticals or injections of medication to break up a blood clot inside an artery or cavity of the heart so that blood flow can be improved or restored. Also called thrombolytics, this type of treatment is widely available at hospitals across the United States.

Mission: Lifeline™

The American Heart Association’s national initiative to improve health care system readiness and response to ST-elevated myocardial infarction (STEMI) patients. It seeks to reduce mortality and morbidity and improve the overall quality of care and outcomes for STEMI patients. The ultimate goal of Mission: Lifeline is to save lives by closing gaps that separate STEMI patients from timely access to appropriate treatments.

Non-PCI hospital

A type of hospital that does not have the means to deliver percutaneous coronary intervention (PCI), the preferred means of treating a STEMI heart attack patient if done within the critical 90-minute window. Non-PCI hospitals can: administer clot-busting medicines that meet the health care needs of non-STEMI patients; refer STEMI patients to PCI hospitals, thus the name PCI-referring hospital; and treat STEMI patients with medications when it is not feasible for them to get to a PCI-capable hospital for treatment in a timely manner.

Non-STEMI heart attack

A type of heart attack caused by a partially blocked blood supply to a portion of the heart. While serious, this type of heart attack is not considered as dangerous as a STEMI heart attack, where an artery in the heart is completely blocking blood flow to a portion of the heart.

Percutaneous coronary intervention (PCI)

The family of medical procedures that uses a "mechanical" means to treat patients with partially or completely restricted blood flow through an artery of the heart. Examples include balloon angioplasty and stents. This type of treatment is available at only about 25% of U.S. hospitals. There are three types of PCI:

Primary PCI: The use of percutaneous coronary intervention to open an occluded coronary artery in the setting of an ST-elevation myocardial infarction

Rescue PCI: PCI that is performed after fibrinolysis/thrombolytics has been performed

Elective PCI: PCI that is not crucial in order to stabilize the patient

PCI-capable hospital

A hospital that has the equipment, expertise and facilities to administer percutaneous coronary intervention (PCI), a mechanical means of treating heart attack patients. Although PCI is the preferred means of treating STEMI patients, only 25% of hospitals in the U.S. are equipped to do so. These PCI-capable hospitals are called STEMI-receiving hospitals because they are well equipped to receive and treat STEMI patients.

Point of Entry (POE)

The part of the healthcare community where treatment of a patient begins, such as when emergency medical services arrive on the scene or the patient walks into the emergency department at a hospital.

Reperfusion therapy

One or more techniques to restore blood flow to part of the heart muscle damaged during a heart attack. It may include clot-dissolving drugs (thrombolysis), balloon angioplasty or surgery.

Revascularization

A procedure used to relieve severe chest pain, or angina, in very ill patients who are not candidates for bypass surgery or angioplasty. Using a laser, the surgeon drills a series of holes from the outside of the heart into its pumping chamber. This procedure is believed to stimulate new blood vessels to grow and/or to destroy nerve fibers to the heart so patients are unable to feel their chest pain.

Secondary prevention

A means to identify and treat people with established cardiovascular disease and those at very high risk of developing such disease; a way to treat and rehabilitate patients who have suffered a heart attack to prevent another cardiovascular or cerebrovascular event.

ST-elevation myocardial infarction (STEMI)

A severe heart attack caused by a prolonged period of blocked blood supply that affects a large area of the heart. These attacks carry a substantial risk of death and disability and call for a quick response by many individuals and systems.

STEMI-receiving hospital

A hospital that has the equipment, expertise and facilities to administer percutaneous coronary intervention (PCI), a mechanical means of treating heart attack patients. Although PCI is the preferred means of treating STEMI patients, only 25% of hospitals in the United States are equipped to do so. These PCI-capable hospitals are called STEMI-receiving hospitals because they are well equipped to receive and treat STEMI patients.

STEMI-referring hospital

A type of hospital that does not have the means to deliver percutaneous coronary intervention (PCI), the preferred means of treating a STEMI heart attack patient if done within the critical 90-minute window. Non-PCI hospitals can: administer clot-busting medicines that meet the health care needs of non-STEMI patients; refer STEMI patients to PCI hospitals, thus the name PCI-referring hospital; and treat STEMI patients with medications when it is not feasible for them to get to a PCI-capable hospital for treatment in a timely manner.

STEMI system

An integrated group of separate entities focused on reperfusion therapy for STEMI within a region that typically includes emergency medical services (EMS) providers, at least one community (non-PCI or STEMI-referring) hospital and at least one tertiary (PCI-capable or STEMI-receiving) hospital. The system may include one or more of the following components: leadership teams of EMS, emergency medicine, cardiology, nursing and administration; standardized communication (i.e., STEMI alert system); standardized transportation; and data collection and feedback. Please note: In some systems, there may be a single hospital with PCI capabilities that has established protocols with EMS providers and contains at least one of the components stated above.

Stent

A wire mesh tube sometimes used in angioplasty that is inserted into an artery to open it, prevent re-blockage and allow the heart to get the blood flow it needs.

Thrombolytics

The use of pharmaceuticals or injections of medication to break up a blood clot inside an artery or cavity of the heart so that blood flow can be improved or restored. Also called fibrinolytic therapy, this type of treatment is widely available at hospitals across the United States.